Mild cognitive impairment (MCI) describes noticeable changes in memory or thinking that don't yet interfere much with daily life. About 15-20% of adults over 65 have MCI, and some go on to develop dementia while others remain stable or improve. Treatment currently focuses on managing risk factors like blood pressure and staying mentally and physically active.
What's actually going on in research
Trials are testing drugs that target amyloid plaques and tau tangles seen in Alzheimer's disease, lifestyle interventions combining exercise with cognitive training, medications that improve brain blood flow, and drugs aimed at inflammation in the brain. Researchers are also studying biomarkers to predict who will progress to dementia and who won't.
Anti-amyloid drugs
Drugs like lecanemab and donanemab, now approved for early Alzheimer's, are being tested in MCI to see if starting treatment earlier slows progression. These antibodies clear amyloid plaques from the brain.
Combination lifestyle programs
Studies are testing whether combining aerobic exercise, cognitive training, diet changes, and social activity can prevent or reverse MCI. Early results suggest multi-component programs may work better than single interventions.
Vascular approaches
Some trials focus on improving blood flow to the brain, since vascular problems contribute to many MCI cases. These include blood pressure control studies and drugs that target small vessel disease.
What to know before you search
Eligibility typically depends on test scores showing mild but measurable memory or thinking problems, age (usually 55 or older), and biomarker evidence of Alzheimer's pathology for some studies.
What types of trials are currently open
- Drug trials — Testing medications that target amyloid, tau, inflammation, or brain cell function to slow or prevent progression to dementia.
- Lifestyle intervention trials — Testing structured programs of exercise, diet, cognitive training, and social engagement to maintain or improve thinking skills.
- Prevention trials — Enrolling people with MCI or at high risk to test whether early treatment can prevent Alzheimer's disease from developing.
- Biomarker studies — Using brain scans, blood tests, and spinal fluid tests to understand who will progress and who might respond to treatment.
- Combination trials — Testing whether combining a drug with lifestyle changes works better than either approach alone.
Recently added Mild Cognitive Impairment trials
Longitudinal Profiling of Plasma-Derived Glial Extracellular Vesicles in Alzheimer's Disease
This project aims to longitudinally profile plasma-derived GDEVs and plasma biomarkers of neuroinflammation across three stages of the AD continuum (Subjective Cognitive Decline, Mild Cognitive Impairment, and Alzheimer's Dementia), exploring their association with biomarkers of amyloidopathy, tauopathy and neurodegeneration, cognitive status and clinical outcome over time. Moreover, GDEVs - collected from subjects at different disease stages - will be used to treat human neurons derived from induced pluripotent stem cells (iPSCs) from healthy controls in order to assess the induced differential neurotoxic or priming effects. This dual translational approach may help identify early pathogenic signatures of neuroinflammation and elucidate their role in disease progression.
Microbiome in Aging of Gut and Brain
The Microbiome in Aging Gut and Brain (MiaGB) Study is an observational study designed to examine whether differences in the microorganisms living in the gut and mouth are associated with cognitive health and cognitive decline. The study includes young healthy adults, cognitively healthy older adults, older adults with mild cognitive impairment (MCI), and older adults with Alzheimer's disease or related dementia. At the baseline visit, participants complete assessments of medical history, cognitive function, physical function, and diet and provide biological samples that may include stool, saliva, oral swabs, blood, and urine. Researchers will study the gut and oral microbiome and related biological factors, including metabolites and markers of intestinal permeability and inflammation, to determine whether these measures differ according to cognitive status. Young healthy adults, cognitively healthy older adults, and participants with MCI will be followed annually for up to 5 years to evaluate changes in the microbiome and cognitive function over time. Participants with Alzheimer's disease or related dementia will participate in the baseline assessment only. No drug, treatment, or other research intervention is assigned as part of this study.
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